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Chinese medicinal herbs for sore throat

Sore throat is a widespread acute respiratory tract illness which affects all age groups. In China, many Chinese herbal medicines are used to treat this illness. Because the majority of clinical research into traditional Chinese medicine (TCM) as a treatment for sore throat failed to meet world standards of clinical research reporting, the authors could not recommend any preparation or formulation for clinical use in the previous published version.

In this updated review, we included a total of 12 studies (including five new studies), involving 1954 participants. Six Chinese herbal medicines may facilitate the improvement of symptoms and increase the rate of recovery. Two studies separately reported one case of diarrhoea and one case of mild nausea; two trials reported no adverse events in the treatment group; and other studies did not report any adverse events. We identified ten studies as being of poor methodological quality and only two studies as being of medium methodological quality. Chinese medicinal herbs may be the treatment choice for sore throat, but we cannot recommend any particular preparation or formulation over another as we did not find any well-designed studies to provide strong evidence to conclusively support or reject the use of Chinese traditional herbal medicines in the treatment of sore throat. Enhancing the quality of research into Chinese medicinal herbs for sore throat is imperative, and stronger evidence from high quality, randomised controlled trials (RCTs) are needed.

Authors' conclusions:

Based on the existing evidence in this review, some Chinese herbal medicines for treating sore throat appeared efficacious. However, due to the lack of high quality clinical trials, the efficacy of Chinese herbal medicine for treating sore throat is controversial and questionable. Therefore we cannot recommend any kind of Chinese medical herbal formulation as an effective remedy for sore throat.

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Background:

Chinese herbal medicines are commonly used to treat sore throat in China and are used worldwide by practitioners of traditional Chinese medicine (TCM). Their efficacy in treating sore throat has not previously been systematically reviewed.

Objectives:

To assess the efficacy and safety of Chinese herbal medicines for patients with sore throat.

Search strategy:

We searched CENTRAL (The Cochrane Library Issue 4, 2011) which contains the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (1966 to week 3, November 2011); EMBASE (1980 to December 2011); AMED (1985 to December 2011); the Chinese Biomedical Database (CBM) (1975 to December 2011); and China National Knowledge Infrastructure (CNKI) (1994 to December 2011).

Selection criteria:

We included randomised controlled trial (RCTs) assessing Chinese herbal medicines for the treatment of sore throat, with the outcomes of recovery, inefficacy, and adverse events.

Data collection and analysis:

The three review authors extracted and analysed the data. One review author contacted the study authors of potential RCTs.

Main results:

We included 12 studies involving 1954 participants. We identified ten studies as being of methodologically poor quality and two studies as being of medium quality. We did not perform a meta-analysis but reported the results separately. Six formulations were shown to be superior to the control in improving recovery: Ertong Qingyan Jiere Koufuye was more effective than Fufang Shuanghua Koufuye for acute pharyngitis (odds ratio (OR) 2.52; 95% confidence interval (Cl) 1.11 to 5.74); Yanhouling mixture was more effective than gentamicin atomised inhalation for acute pharyngitis (OR 5.39; 95% CI 2.69 to 10.81); Qinganlan Liyan Hanpian was more effective than Fufang Caoshanhu Hanpian for acute pharyngitis (OR 2.25; 95% CI 1.08 to 4.67); sore throat capsules were more effective than antibiotics (intravenous cefalexin) for acute pharyngitis or acute tonsillitis (OR 2.36; 95% CI 1.01 to 5.51); compound dandelion soup was more effective than sodium penicillin for acute purulent tonsillitis (OR 5.06; 95% CI 1.70 to 15.05); and eliminating heat by nourishing yin and relieving sore-throat methods combined with Dikuiluqan Hanpian was more effective than Dikuiluqan Hanpian alone for children with chronic pharyngitis (OR 2.63; 95% CI 1.02 to 6.79). Another six formulations were shown to be equally efficacious as the control.

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